Cardiac Autonomic Nervous System and Ventricular Arrhythmias: The Role of Radionuclide Molecular Imaging

Abstract

Widely established compared to myocardial perfusion imaging, cardiac autonomous nervous system (CANS) assessment by radiopharmaceutical means is of potential use especially to arrhythmogenic diseases not correlated with anatomic or functional alterations revealed by classical imaging techniques. Molecular imaging of both pre- and postsynaptic functions of the autonomous nervous system is currently feasible, since single photon emission tomography (SPECT) and positron emission tomography (PET) have the ability to reveal the insights of molecular pathophysiology depicting both sympathetic and parasympathetic imbalance in discrete heart pathologies. This review provides not only a brief presentation of radiopharmaceuticals used for non-invasive CANS imaging in the case of ventricular arrhythmias, but also a current update on ventricular tachycardias, cardiomyopathies, Brugada and Long QT syndrome literature.

Arrhythmia conversion to sinus rhythm during a hypnosis: Is hypnosis a normal bystander or a guilty accomplice?

“…From a pathophysiological point of view, the effect of hypnosis on cardiac arrhythmias is still little understood although the modulation of the autonomic nervous system (ANS) seems to play a key role. Autonomic dysfunction and/or an imbalance between sympathetic and parasympathetic tone plays a clear role in the pathogenesis of arrhythmias such as ventricular arrhythmias or even sudden death [16] , [17] . The mechanisms by which the ANS is either arrhythmogenic or on the contrary antiarrhythmic are complex and specific for each arrhythmia.…”

(Use of multimodal imaging in patients with multiple ventricular extrasystoles - pilot results)

“…Nejčastěji jsou KES asociovány s výskytem setrvalé komorové tachykardie, 6 zejména v návaznosti na ischemické postižení. 7 Při absenci strukturálního onemocnění srdce či absenci genetické kanálopatie jsou KES popisovány jako idiopatické.…”

Strain Imaging and Ventricular Arrhythmia

“…Given the constraints of LVEF and the varying pathophysiological mechanisms that may promote the development of VAs, several studies have evaluated the potential prognostic utility of other biomarkers in the context of VAs. These include electrocardiographic markers as well as findings from cardiac magnetic resonance imaging, computed tomography, radionuclide imaging, and novel echocardiographic techniques [8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”